Klemencsics Z L, Kiss R M
Fóvárosi Onkormányzat Weiss Manfréd Kórháza.
Orv Hetil. 2001 Feb 4;142(5):227-33.
The etiology and predisposing factors of spondylolysis and spondylolisthesis, which are summarized in the first part of this article, have received considerable attention, but there biomechanics is little published. The goal of this article is to show a biomechanical model for the development of spondylolysis and spondylolisthesis. With mechanical equations it has been established, the pars interarticularis and the ligaments resist together the tensile and shear force, the bending moment if the pars interarticularis is uncracked. If the tensile stress in the pars interarticularis reaches its strength, crack occurs and the spondylolysis is developed. The cracked pars interarticularis is no longer capable of sustaining tension, the tensile force is transferred to the ligament. When the compressive strain of the pars interarticularis reaches its strain limit, the spondylolisthesis does not develop, because the vertebra can not slip with the unbroken ligaments. If the loading on the pars interarticularis would be decreasing, the cracks close and the pars interarticularis can ossify. If the tensile stress in the ligament reaches its strength and the ligament breaks, the pars interarticularis cracks through, the vertebra slips and the spondylolisthesis develops. In the last part of the article the methods of the conservative and operative treating are summarized.
本文第一部分总结了椎弓根峡部裂和椎体滑脱的病因及诱发因素，这些内容已受到广泛关注，但关于其生物力学的研究报道较少。本文旨在展示一个关于椎弓根峡部裂和椎体滑脱发展的生物力学模型。通过力学方程已证实，当椎弓根峡部完整时，椎弓根峡部和韧带共同抵抗拉伸力、剪切力及弯矩。当椎弓根峡部的拉应力达到其强度时，便会出现裂缝，进而发展为椎弓根峡部裂。出现裂缝的椎弓根峡部不再能够承受拉力，拉力会转移至韧带。当椎弓根峡部的压缩应变达到其应变极限时，椎体滑脱不会发生，因为椎体在韧带未断裂的情况下无法滑动。如果作用于椎弓根峡部的负荷减小，裂缝会闭合，椎弓根峡部可能会骨化。当韧带中的拉应力达到其强度且韧带断裂时，椎弓根峡部会完全裂开，椎体发生滑移，进而发展为椎体滑脱。本文最后一部分总结了保守治疗和手术治疗的方法。
